ESCRS - PO0648 - Epidemiology, Clinical Features And Therapeutic Management Of Fungal Keratitis: A 10-Year Retrospective Single-Center Study

Epidemiology, Clinical Features And Therapeutic Management Of Fungal Keratitis: A 10-Year Retrospective Single-Center Study

Published 2023 - 41st Congress of the ESCRS

Reference: PO0648 | DOI: 10.82333/sy79-w984

Authors: Jorge Duque García* 1 , Lourdes Salgueiro Tielas 1 , June Artaechevarria Artieda 1 , José Javier San Román Llorens 1 , Natalia Lorenzana Blanco 1 , Blanca García Sandoval 1 , Nicolas Alejandre Alba 1 , Ignacio Jiménez-Alfaro Morote 1

1Fundación Jiménez Díaz,Madrid,Spain

The aim of this study is to describe the characteristics, clinical approach, and therapeutic management of fungal keratitis in a tertiary referral Spanish hospital over the last ten years.

Tertiary referral hospital Fundación Jiménez Díaz, Madrid, Spain.

 

This is a retrospective study that included patients with a culture confirmed diagnosis of fungal keratitis between January 2012 and October 2022. A complete ophthalmological exploration was performed at diagnosis and during all follow-up visits. The data collected included demographics, risk factors, microorganism, antibiogram, best corrected visual acuity (BCVA) in decimal scale at diagnosis and at resolution, type of topical antifungals and duration, intrastromal or intracameral antifungal injections, eventual need of penetrating keratoplasty (PKP) and complications.

26 eyes of 24 patients were included, with a mean age of 56,46 years old. The main risk factors were the use of contact lenses(48%) and surgical history(32%). BCVA at diagnosis was 1,39 logMAR, and 1,06 logMAR at resolution. The main isolated microorganisms were Candida(38%), Fusarium(34%) and Aspergillus(12%). No resistances to antifungal agents were found. All patients received topical treatment with 1 or 2 antifungals(Voriconazol 1%, Natamicyn 5% or Amphotericin-B 0.15%), in a range of 2-7 weeks. Oral antifungals were added in 15 patients(57,7%). Intrastromal and intracameral injections were performed in 4 patients(15,38%), 5 underwent PKP(19,2%) and 1 enucleation(3,8%).

Fungal keratitis is a severe corneal infection with a complex clinical approach that can severely affect visual acuity. They are more prevalent in developing countries, where filamentous fungi are most common. In developed countries, however, yeasts are more frequent and relate to the use of contact lenses and surgical history, which correlates with our results. Treatment is very variable, with no specific guidelines available, and should be individualized in every case